What is Pancreatic Cancer?

Cancer begins when abnormal cancerous cells grow together to form masses called tumors. Pancreatic cancer can start in the tissues of the pancreas, which lies behind the lower part of the stomach and helps with digestion and controls blood sugar. Pancreatic cancer is sometimes called a “silent disease” because it may not cause symptoms in the early stages. Pancreatic cancer is usually diagnosed at more advanced stages.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of pancreatic cancer. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Pancreatic cancer signs and symptoms often do not appear until the cancer is well advanced. When signs and symptoms of pancreatic cancer do appear, they can include:

• Pain or cramps in the upper abdomen and back
• Yellowish color of skin and eyes (jaundice)
• Loss of appetite and weight loss for no known reason
• Sudden onset diabetes or change in blood-sugar control for people with diabetes
• Blood clots
• Frequent nausea, vomiting and indigestion

Diagnosis

An early diagnosis of pancreatic cancer can be missed because this type of cancer often does not have symptoms until the cancer is well advanced. To diagnose pancreatic cancer, we start with a physical exam. If pancreatic cancer is suspected, we use advanced diagnostic procedures and technology to effectively inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Biopsy: During this procedure, a sample of tissue is removed from the pancreas or tumor for laboratory testing. Testing can tell the physician whether the tissue is cancerous and the cancer’s grade. A biopsy can be performed using a needle or during a minimally invasive imaging procedure from inside the pancreas.

Blood test: Blood tests check for bilirubin and other body functions. Blood tests can also check for an increased level of proteins that can indicate pancreatic cancer. However, elevated protein levels can be caused by conditions other than pancreatic cancer.

Computed tomography (CT) scan: During this imaging test, a series of detailed pictures, taken from different angles, are created by a computer linked to an X-ray machine. A CT scan can also be used to guide a biopsy procedure.

Transabdominal ultrasound: During this test, an ultrasound device is placed on the abdomen and slowly moved to create a picture of the pancreas or other organs.

Endoscopic ultrasound (EUS): During this imaging test, the doctor passes a small lighted tube through the patient’s mouth, into the patient’s stomach and down into the small intestines. An ultrasound device at the end of the tube produces images of the pancreas, surrounding organs and tissues. This type of ultrasound can also be used to guide a biopsy procedure.

Endoscopic retrograde cholangiopancreatography (ERCP): During this test, the doctor passes a small scope through the patient’s mouth to the abdomen into the area of the pancreatic ducts. Dye is injecting through the scope and X-rays are taken that can show if the ducts are blocked or narrowed by a tumor or other condition. During this procedure, a small tube (stent) can be placed to relieve jaundice associated with pancreatic cancer. 

Causes

The cause of pancreatic cancer is unknown, but certain lifestyle factors can increase the risk for pancreatic cancer. These include:

• Obesity
• Smoking and smokeless tobacco use

Risk Factors

Risk factors that may contribute to pancreatic cancer include:

Age: Pancreatic cancer is rarely found in people under the age of 50.

Chronic pancreatitis: Chronic pancreatitis is associated with an increased risk of pancreatic cancer, especially in those who smoke.

Diabetes: Those with Type 2 diabetes may be at risk for pancreatic cancer.

Family history: People with a family history of pancreatic cancer, pancreatitis and heredity conditions like Von Hippel-Lindau syndrome or ataxia-telangiectasia, are at higher risk for developing pancreatic cancer.

Race: African-Americans have a slightly higher risk of pancreatic cancer.

Gender: Men have a slightly higher incidence of pancreatic cancer.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent pancreatic cancer:

Don’t smoke: Smoking is known to increase the risk of pancreatic cancer.

Eat a low-fat diet: Eat a healthy low-fat diet that includes plenty of fruit and vegetables, and exercise daily.

Maintain a healthy weight: Lose excess weight and maintain a healthy weight.

Know your history: Know your family history and talk to your doctor about your specific risk.

Prognosis

The pancreatic cancer survival rate depends upon how early the cancer is diagnosed and if it has spread.

Treatment and Recovery

Pancreatic cancer treatment depends on how large the tumor is and the general health of the person. Frequently, multiple types of treatments are necessary, including:

Surgery

Surgery for pancreatic cancer is done to remove as much of the cancer as possible, and/or to relieve symptoms. Surgeries can include:

• Whipple procedure (pancreaticoduodenectomy): In this procedure, the part of the pancreas with cancer is removed, as well as part of the stomach, small intestine, gall bladder, common bile duct and nearby lymph nodes.
• Pancreatectomy: This surgical procedure can be used to remove part or all of the pancreas.

• Stent placement: If the cancer has blocked the bile duct, a surgical procedure can be done to place a stent (a mesh tube) into the duct to keep it open.

Recovery After Surgery

Recovery after a surgical procedure will depend upon the type of procedure and your overall health. Your doctor will tell you when you may be physically active again and about what activities to avoid during recuperation.

Chemotherapy

Chemotherapy uses special drugs designed to kill cancer cells. Chemotherapy can be administered as a pill or injected into the bloodstream and may be given before surgery to shrink a tumor, after surgery to kill remaining cancer cells and as a means of reducing symptoms.

Radiation Therapy

This treatment uses high-energy radiation to kill cancer cells. The radiation is directed specifically to the pancreas. Most often, radiation treatments are given five days a week for several weeks. 

Targeted therapy

Targeted therapy uses specific drugs that block signals in cancer cells and prohibit them from growing, spreading and surviving.

Complications

 If pancreatic cancer is not diagnosed and treated early, the cancer can spread to other organs. Other complications can include:

• Jaundice
• Obstruction of the intestines or stomach
• Pain
• Problems eating or swallowing